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General NPI Number Information
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NPI Number | 1730988387
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Entity Type | Organization
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Legal Business Name | ASCEND AUTISM MEDICAL DIAGNOSTIC SERVICES PLLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 15 KETCHUM ST LOWR LEVEL
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City | WESTPORT
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State | CT
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Zip | 06880-5959
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Country | US
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Telephone | 877-323-8668
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Fax | 203-547-6280
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Provider Business Mailing Address
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Address Line | 22 SAW MILL RIVER RD STE 308
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City | HAWTHORNE
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State | NY
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Zip | 10532-1533
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Country | US
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Telephone | 877-323-8668
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Fax | 203-547-6280
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | NATHAN KRONFORST
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Credential |
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Telephone | 617-233-9907
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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